Rituxan Rituximab
Take the targeted path to treatment for B-cell
non-Hodgkin's lymphoma (NHL)

Proposed Mechanism of Action

RITUXAN targets CD20+ B-cells1

RITUXAN is a monoclonal antibody for the treatment of certain types of Non-Hodgkin's Lymphoma. It works with the human immune system to induce B-cell lysis through several proposed mechanisms, based on in vitro data.1

Proposed Mechanism of Action Video

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Proposed Mechanism of Action

    This video depicts:
  • An introduction to RITUXAN's Proposed Mechanism of Action
  • ADCC (antibody-dependent cell-mediated cytotoxicity)
  • CDC (complement-dependent cytotoxicity)
  • Apoptosis

Possible mechanisms of cell lysis1-3

ADCC

RITUXAN B-cell mechanism of action

  • ADCC (antibody-dependent cell-mediated cytotoxicity): Natural killer cells, T cells, and macrophages recognize and kill antibody-labeled target cells, leading to cell lysis

CDC

RITUXAN B-cells and Cell lysis

  • CDC (complement-dependent cytotoxicity): Binding of the antibody recruits complement proteins, which punch holes in the cell membrane, flooding the cell and leading to cell lysis

Apoptosis

RITUXAN and Apoptosis

  • Apoptosis: Binding of the antibody signals the cell to self-destruct resulting in cell lysis

View Indication and Safety Information
Professional Resources

INDICATIONS AND IMPORTANT SAFETY INFORMATION

RITUXAN® (Rituximab) is indicated for the treatment of patients with:

  • Previously untreated and previously treated CD20-positive CLL in combination with fludarabine and cyclophosphamide (FC)
  • Relapsed or refractory, low-grade or follicular, CD20-positive, B-cell NHL as a single agent
    • Weekly ×4
    • Weekly ×8
    • Bulky disease
    • Retreatment
  • Previously untreated follicular, CD20-positive, B-cell NHL in combination with CVP chemotherapy
  • Non-progressing (including stable disease), low-grade, CD20-positive, B-cell NHL, as a single agent, after first-line CVP chemotherapy
  • Previously untreated diffuse large B-cell, CD20-positive NHL in combination with CHOP or other anthracycline-based chemotherapy regimens

RITUXAN is not recommended for use in patients with severe, active infections.

WARNING: FATAL INFUSION REACTIONS, TUMOR LYSIS SYNDROME (TLS), SEVERE MUCOCUTANEOUS REACTIONS, and PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY (PML)

Infusion Reactions: RITUXAN administration can result in serious, including fatal, infusion reactions. Deaths within 24 hours of RITUXAN infusion have occurred. Approximately 80% of fatal infusion reactions occurred in association with the first infusion. Carefully monitor patients during infusions. Discontinue RITUXAN infusion and provide medical treatment for Grade 3 or 4 infusion reactions.

Tumor Lysis Syndrome (TLS): Acute renal failure requiring dialysis with instances of fatal outcome can occur in the setting of TLS following treatment of non-Hodgkin’s lymphoma (NHL) with RITUXAN monotherapy.

Severe Mucocutaneous Reactions: Severe, including fatal, mucocutaneous reactions can occur in patients receiving RITUXAN.

Progressive Multifocal Leukoencephalopathy (PML): JC virus infection resulting in PML and death can occur in patients receiving RITUXAN.

RITUXAN has also been associated with other serious and/or fatal adverse reactions. These include hepatitis B reactivation with fulminant hepatitis, other infections, cardiovascular events, renal toxicity, and bowel obstruction and perforation.

The most common adverse reactions of RITUXAN (incidence ≥25%) observed in clinical trials of patients with NHL were infusion reactions, fever, lymphopenia, chills, infection, and asthenia. The incidence of infusion reactions was highest during the first infusion (77%) and decreased with each subsequent infusion. These infusion reactions typically resolved with slowing or interruption of the infusion and with supportive care. The most frequent Grade 3 or 4 adverse reactions observed in NHL were cytopenias.

The most common adverse reactions of RITUXAN (incidence ≥25%) observed in clinical trials of patients with CLL were infusion reactions and neutropenia. Infusion-related adverse reactions occurring during or within 24 hours of the start of infusion included nausea, pyrexia, chills, hypotension, vomiting, and dyspnea. Most patients treated with R-FC experienced at least one Grade 3 or 4 adverse reaction. The Grade 3 or 4 adverse reactions observed more frequently with R-FC compared with FC alone were neutropenia, leukopenia, febrile neutropenia, thrombocytopenia, infusion reactions, pancytopenia, hypotension, and hepatitis B.

In clinical trials, CLL patients 70 years of age or older who received R-FC had more Grade 3 and 4 adverse reactions compared with younger CLL patients who received the same treatment.

For additional safety information, please see the full prescribing information, including BOXED WARNINGS and Medication Guide.

Attention Healthcare Provider: Provide Medication Guide to patient prior to RITUXAN infusion.

References
  1. RITUXAN® (Rituximab) full prescribing information, Genentech, Inc., 2008.
  2. DiJulio JE. Monoclonal antibodies: overview and use in hematologic malignancies. In: Rieger PT, ed. Biotherapy: A Comprehensive Overview. 2nd ed. Sudbury, Mass: Jones and Bartlett Publishers; 2001:283-316.
  3. Maloney DG, Smith B, Rose A. Rituximab: mechanism of action and resistance. Semin Oncol. 2002; 29(suppl 2):2-9.